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OBJECTIVE To calculate the cost of centralized dispensing of four categories of drugs (ordinary drugs, antibacterial drugs, hazardous drugs, and parenteral nutrition solutions) in pharmacy intravenous admixture service (PIVAS), and provide reference for setting charging standards for relevant departments. METHODS The operating costs of PIVAS in 12 medical institutions from Shaanxi province were collected through questionnaire survey, including labor costs, medical and health material costs, fixed asset depreciation and repair costs, water and electricity costs, and management costs. The operation time allocation coefficient method and workload allocation coefficient method were comprehensively used to allocate the above costs, and the unit preparation costs of four categories of drugs were calculated. RESULTS The average annual total costs of dispensing ordinary drugs, antibacterial drugs, hazardous drugs, and parenteral nutrition solutions in Shaanxi province were (2 195 900.25±1 680 893.73) yuan, (746 341.59±725 839.39) yuan, (331 420.15±183 258.83) yuan, and (330 322.68±277 281.70) yuan, respectively, with labor costs accounting for the highest proportion, averaging 85.49%. The costs of dispensing a set of ordinary drugs, antibacterial drugs, and hazardous drugs were 5.89, 7.60, and 14.37 yuan, respectively; the cost of dispensing one bag of parenteral nutrition solution was 32.15 yuan (excluding the cost of disposable intravenous nutrition bags). CONCLUSIONS The cost calculation method and data of different types of intravenous drugs obtained in this study can provide reference for relevant departments to formulate and adjust PIVAS fee standards.
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OBJECTIVE To calculate the cost of centralized dispensing of four categories of drugs (ordinary drugs, antibacterial drugs, hazardous drugs, and parenteral nutrition solutions) in pharmacy intravenous admixture service (PIVAS), and provide reference for setting charging standards for relevant departments. METHODS The operating costs of PIVAS in 12 medical institutions from Shaanxi province were collected through questionnaire survey, including labor costs, medical and health material costs, fixed asset depreciation and repair costs, water and electricity costs, and management costs. The operation time allocation coefficient method and workload allocation coefficient method were comprehensively used to allocate the above costs, and the unit preparation costs of four categories of drugs were calculated. RESULTS The average annual total costs of dispensing ordinary drugs, antibacterial drugs, hazardous drugs, and parenteral nutrition solutions in Shaanxi province were (2 195 900.25±1 680 893.73) yuan, (746 341.59±725 839.39) yuan, (331 420.15±183 258.83) yuan, and (330 322.68±277 281.70) yuan, respectively, with labor costs accounting for the highest proportion, averaging 85.49%. The costs of dispensing a set of ordinary drugs, antibacterial drugs, and hazardous drugs were 5.89, 7.60, and 14.37 yuan, respectively; the cost of dispensing one bag of parenteral nutrition solution was 32.15 yuan (excluding the cost of disposable intravenous nutrition bags). CONCLUSIONS The cost calculation method and data of different types of intravenous drugs obtained in this study can provide reference for relevant departments to formulate and adjust PIVAS fee standards.
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Objective To develop an accurate deep learning prediction model of YOLO-V5 capable of accurately iden-tifying medication packaging boxes in outpatient and emergency pharmacies,aiming to assist pharmacists in achieving"zero dis-pensing error".Methods A total of 2 560 images of packaging boxes from 136 different drugs were collected and labeled to form the deep learning dataset.The dataset was split into training and validation sets at a ratio of 4∶1.YOLO-V5 deep-learning algorithm was employed for training the data using images from our dataset(train epochs:500,batch size:4,learning rate:0.01).The values of the precision(Pr)and mean average precision(mAP)were used as measures for model performance evaluation.Results The Pr of the four sub-models of YOLO-V5 in the training set all reached 1.00.The mAP_0.5 of YOLO-V5x was 0.95,which was higher than those of YOLO-V5s(0.94),YOLO-V5l(0.94),and YOLO-V5m(0.94).The mAP_0.5:0.95 of YOLO-V5l and YOLO-V5x were 0.85 which were higher than those of YOLO-V5s(0.84)and YOLO-V5m(0.84).Training time and model size were 82.56 hours and 166.00MB for YOLO-V5x which were the highest among the four models.The speed of detection in one im-age was 11ms for YOLO-V5s which was the fastest among the four models.Conclusion YOLO-V5 can accurately identify the packaging of drugs in outpatient and emergency pharmacies.Implementing an artificial-intelligence-assisted drug dispensation sys-tem is feasible for pharmacists to achieve"zero dispensing error".
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The policy of long-term prescription for chronic diseases in China is gradually being improved and implemented, and external long-term prescription dispensing is being encouraged. The long-term prescription policy runs through the links of drug supply, equipment, use and policy, involving government departments such as medical security and health, as well as stakeholders such as patients, medical institutions and designated detail pharmacies. There are still some problems in the external dispensing of long-term prescriptions, such as the disunity of drug catalogue and the need for coordination among regulatory parties in the policy link; the need to improve the participation enthusiasm and service ability in the equipment link; the increased difficulty of prescription management, the need to improve the circulation platform in the use link. The promotion of external long-term prescription policy requires health insurance, medical service, and the medicine industry co-development, multi-party participation, and policy coordination. Among them, the “dual channel” policy, the policy of centralized medicine procurement, and the pharmacy included in outpatient overall management policy have all played a positive role in promoting the implementation of external long-term prescription dispensing for chronic diseases. It is necessary to improve supporting policies and implement regulatory responsibilities in the policy link, promote drug classification and service capabilities in the equipment link, improve the electronic prescription circulation platform, and strengthen prescription management in use link, so as to promote the implementation of external long-term prescription dispensing.
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OBJECTIVE To construct the simulated traditional Chinese medicine pharmacy based on virtual simulation technology, and assist in the development of the new mode of traditional Chinese medicine dispensing education training. METHODS The field research and questionnaire surveys were conducted to identify the needs of Chinese medicine students and practitioners for the content and presentation of knowledge on the construction of simulated traditional Chinese medicine pharmacy. Taking the laws and regulations on the construction of traditional Chinese medicine pharmacy and the related teaching materials and literature on traditional Chinese medicine preparation as the knowledge source, the virtual simulation technology was applied to build a simulated traditional Chinese medicine pharmacy so as to achieve the functions of browsing the traditional Chinese medicine pharmacy, learning the knowledge of traditional Chinese medicine preparation and practical skills training. A multi-site simulated traditional Chinese medicine pharmacy evaluation scale study was conducted based on platform operational testing. RESULTS A simulated traditional Chinese medicine pharmacy was constructed, consisting of four core modules: video teaching, animation video, simulated pharmacy, and simulated experience. The overall score of evaluation scale was 93.31, with all entries scoring above 80; the ones with evaluation scales above 90 accounted for 92.31% (60/65). CONCLUSIONS Simulated traditional Chinese medicine pharmacy based on virtual simulation technology meets the learning needs of users and enhances the teaching effect of traditional Chinese medicine dispensing technology training.
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ObjectiveTo establish an allele-specific polymerase chain reaction (PCR) method for identifying Scolopendra dispensing granules, so as to ensure the quality and therapeutic effects of Scolopendra and its preparations. MethodThe primer interval suitable for the PCR was selected based on the cytochrome c oxidase subunit 3(COX-3) gene sequence of Scolopendra, and the single nucleotide polymorphism (SNP) loci of Scolopendra and its adulterants were mined from the interval for the design of specific primers. The samples of Scolopendra and its adulterants were collected. The PCR system was established and optimized regarding the annealing temperature, cycles, Taq enzymes, DNA template amount, PCR instruments, and primer concentrations, and the specificity and applicability of this method were evaluated. ResultThe PCR system was composed of 12.5 μL 2×M5 PCR Mix, 0.4 μL forward primer (10 μmol·L-1), 0.4 μL reverse primer (10 μmol·L-1), 2.5 μL DNA template, and 9.2 μL sterile double distilled water. PCR parameters: Pre-denaturation at 94 ℃ for 3 min, 30 cycles (94 ℃ for 20 s, 62 ℃ for 20 s, 72 ℃ for 45 s), and extension at 72 ℃ for 5 min. After PCR amplification with the system and parameters above, the electrophoresis revealed a bright band at about 135 bp for Scolopendra and no band for the adulterants. ConclusionThe established allele-specific PCR method can accurately identify the medicinal materials, decoction pieces, and standard decoction freeze-dried powder of Scolopendra, as well as the intermediates and final products of Scolopendra dispensing granules, which is of great significance for ensuring the quality and clinical efficacy of Scolopendra and its preparations.
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OBJECTIVE To reduce dispensing errors in pharmacy intravenous admixture service (PIVAS) of children’s hospitals. METHODS The risk of dispensing procedures in our PIVAS was identified by applying failure mode and effect analysis (FMEA) model. Potential failure modes that might lead to dispensing errors in each link were determined, and failure causes were analyzed. The severity, incidence and detection degree of potential failure modes were quantitatively scored, and their risk priority number (RPN) was calculated to screen failure modes that needed to be improved in priority; the corresponding improvement measures were developed by 6S management method from six aspects, namely, finishing (seiri), rectifying (seiton), sweeping (seiso), sanitation (seiketsu), literacy (shitsuke) and safety. The effect of intervention before and after rectification was evaluated. RESULTS Based on the RPN, 32 potential failure modes were selected, of which a total of 18 critical failure modes that needed to be improved in priority. After implementing corresponding measures according to 6S management method, the RPN of 18 critical failure modes decreased. The total RPN decreased from 497 to 142 with a decrease rate of 71.43%. The error rates of 15 critical failure modes were significantly lower than before implementation (P<0.05). CONCLUSIONS Applying FMEA model and 6S management method to the risk control of all aspects of PIVAS workflow can effectively reduce the risk of PIVAS dispensing errors and ensure the safety of children’s intravenous medication.
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Background: South African pharmacies face challenges like cost reduction, inventory management, and employee efficiency. Balancing dispensing error rates and customer satisfaction, along with ensuring accurate medication dispensing, is also crucial. An effective solution to these challenges is adopting automatic robotic dispensing systems, which enhance stock inventory management, integrated systems, and accurate dispensing capabilities. Objectives: The study delved into IT and robotic automation in South African pharmaceutical dispensing, assessing current methods and advocating for integrated IT and Automated Storage and Retrieval Systems in retail and hospital pharmacies. Method: The research used a quantitative approach to gather data from public and private hospital pharmacy employees, aiming to understand their requirements and expectations. It assessed the potential improvements that could result from adopting a new system. Results: The study found that most government and private pharmacies in South Africa prefer automated dispensing systems to reduce errors, lower costs, improve customer service, and enhance inventory management. Benefits also included minimising medication errors, improving operational efficiency, and ensuring patient safety. Conclusion: The study holds importance as it underscores the necessity of integrating Information Technology (IT) and Robotic Automation in the pharmaceutical sector to address prevailing issues. It identifies factors contributing to medication dispensing errors and demonstrates the potential of automated robotic systems in mitigating these errors. Contribution: South Africa's pharmaceutical sector must enhance efficiency and competitiveness by adopting integrated IT and Robotic Automation Systems. The study identified key factors for future implementation and emphasized the need for clear pre-implementation policies outlining functions and benefits.
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Objective To construct the auxiliary system of outpatient drug distribution, reduce errors and improve the quality of outpatient pharmaceutical service. Methods The bar code technology was used to independently develop outpatient pharmacy dispensing assistant system. The system design and function are introduced. The practical application effect of the system was evaluated on dispensing errors, efficiency and pharmacist evaluation. Results Based on the special network environment of the hospital, the system integrated the functions of drug check, prescription right management, expiration date management and medication instruction. After using the system, the number of dispensing errors decreased from 84 to 25. The waiting time for patients to receive medicine decreased by 151 seconds. All pharmacists surveyed agreed that auxiliary system was helpful to pharmacists’ work. Conclusion The system reduced the medication dispensing error in outpatient pharmacy, improved work efficiency and the quality of pharmaceutical care.
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ObjectiveTo establish the quality standard for Fraxini Cortex(Fraxinus chinensis) dispensing granules based on standard decoction, and to provide a basis for the quality control of this dispensing granules. MethodHigh performance liquid chromatography(HPLC) specific chromatograms of 15 batches of Fraxini Cortex(F. chinensis) standard decoctions and 3 batches of Fraxini Cortex(F. chinensis) dispensing granules were established with the mobile phase of 0.1% phosphoric acid aqueous solution(A)-acetonitrile(B) for gradient elution(0-10 min, 12%-15%B; 10-30 min, 15%-32%B) and the detection wavelength of 220 nm. And similarity evaluation, cluster analysis and principal component analysis(PCA) were also carried out. HPLC quantitative analysis of multi-components by single marker(QAMS) was established to determine the contents of the main components in the standard decoctions and dispensing granules. The contents of the corresponding components in Fraxini Cortex(F. chinensis) decoction pieces were also detected, and the transfer rates from decoction pieces to standard decoctions and dispensing granules were calculated. ResultThe similarities between specific chromatograms of 15 batches of Fraxini Cortex(F. chinensis) standard decoctions and 3 batches of Fraxini Cortex(F. chinensis) dispensing granules were all>0.9, and 7 common peaks were identified. The results of cluster analysis and PCA showed that there was some differences in the composition of different batches of standard decoctions, but did not show aggregation of origin. As the standard decoctions, the extract rate was 6.18%-11.62%, the contents of esculin, syringin, fraxin, esculetin, fraxetin, calceolarioside B were 44.92-103.51, 1.36-11.87, 33.26-90.73, 4.63-29.75, 2.40-16.86, 2.49-17.35 mg·g-1, and the transfer rates from decoction pieces to standard decoction were 25.21%-42.54%, 52.57%-88.84%, 43.43%-79.45%, 49.15%-88.27%, 49.22%-72.69%, 27.66%-47.67%, respectively. The extract rates of Fraxini Cortex(F. chinensis) dispensing granules were 10.4%-10.7%, the transfer rates of the above six components from decoction pieces to dispensing granules were 42.76%-43.17%, 80.01%-80.90%, 59.59%-59.88%, 51.35%-52.67%, 60.50%-60.93%, 37.98%-38.37%, respectively, which were generally consistent with the transfer rates from decoction pieces to standard decoctions. ConclusionThe established quality control standard of Fraxini Cortex(F. chinensis) dispensing granules based on standard decoctions is reasonable and reliable, which can provide reference for the quality control and process research of this dispensing granules.
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OBJECTIVE To provide reference for improving the dispensing accuracy of similar drugs and reducing dispensing error risk through exploring the dispensing mode of similar drugs. METHODS The effectiveness and feasibility of the similar drug dispensing management mode was explored through adjusting the traditional horizontal or vertical sorting method to a “Z” shaped cargo location sorting, implementing similar drug in different zones dispensed by different people, and combining measures such as adjusting the format of drug dispensing documents and improving inventory methods. The role of similar drug dispensing mode in drug dispensing management was evaluated comprehensively from two aspects: work quality and work efficiency. RESULTS After the implementation of similar drug dispensing mode, total number of monthly dispensing errors (18.42±8.79 vs. 28.50±6.87,P= 0.005) and the proportion of monthly dispensing errors of similar drugs ([ 4.17±5.71)% vs. (10.96±7.05)%,P=0.017] were significantly lower than before the implementation; the monthly consistency rate between accounts and materials ([ 98.46±0.73)% vs. (97.61±0.57)%, P=0.004] was significantly higher than before implementation; completion time of dispensing in each batch was not significantly affected, and daily work was carried out smoothly and orderly. CONCLUSIONS The similar drug dispensing mode has a significant effect in improving the accuracy of dispensing similar drugs, reducing the risk of dispensing errors, and does not affect the efficiency of dispensing work.
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In order to standardize the quality control of traditional Chinese medicine(TCM) dispensing granules, the Chinese Pharmacopoeia Commission has promulgated and implemented 200 national drug standards for TCM dispensing granules, but there are still varieties of TCM dispensing granules without unified standards. Many provinces have actively invested in the formulation of provincial standards for TCM dispensing granules to make up for the gaps in standards for varieties of traditional Chinese medicine dispensing granules other than the national standards. By the end of July 2022, 29 provincial-level administrative regions have successively promulgated and implemented a total of 5 602 provincial standards for TCM dispensing granules, involving more than 400 varieties. In order to better understand the formulation and characteristics of provincial standards, this study took 105 provincial standards that have been promulgated and implemented in Henan province as an example, and comprehensively analyzed the formulation and characteristics through quality control indicators such as dry extract rate of raw materials, contents of index components and their transfer rates, specifications and so on. The formulation and characteristics of the same TCM dispensing granules in the provincial standards of different provinces were further analyzed, in order to provide reference for the formulation of provincial standards of TCM dispensing granules and the implementation of national standards.
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Strengthening the standard formulation and quality management of traditional Chinese medicine(TCM) dispensing granules is an important part of the strategic planning for the development of TCM in China. In order to examine the clinical application and overall quality control of the existing national standards for TCM dispensing granules, this study classified and summarized the varieties in the existing standards, analyzed their clinical applicability, and discussed the characteristics of the test methods for identification, content determination and specific chromatogram/fingerprint. It was found that the coverage of the existing standards was inadequate in terms of quantity, and it was even weaker in the aspects of therapeutic efficacy, herb family, processing method and preparation method of TCM dispensing granules. It was concluded that the characteristics of national standards in test methods were summarized as follows:guided by clinical application, based on the reference system, taking specific chromatogram as a breakthrough, so as to improve the overall quality control of TCM dispensing granules. It is suggested that the coverage of national standards should be subsequently expanded to meet the needs of market development. In order to enhance clinical applicability, the content of national quality standards should be increased, including increasing variety diversity to meet the needs of clinical application, raising the standard requirements to improve the clinical medication experience, and strengthening effectiveness research to highlight clinical efficacy. At the same time, the accessibility of regulatory inspection is enhanced, the rules for the management of varieties without national standards are promulgated to lay the foundation for the healthy and orderly development of TCM dispening granule industry.
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As an important complementary form of decoction pieces of traditional Chinese medicine(TCM), TCM dispensing granules has the advantages of being free of decoction, easy to take, easy to carry and easy to be dispensed, which greatly improves the capacity of emergency services of TCM and is more in line with the needs of modern society. With the end of the pilot project of TCM dispensing granules, the market has been fully liberalized, the competition has been intensified, and it is in the transition period of switching between the new standard and the old one, and there are some problems such as the shortage of varieties, the change of specifications and the difference of quality, and the production enterprises are facing new opportunities and challenges. Based on this, the authors intend to systematically sort out the policies and regulations, enterprise layout and standard formulation since the pilot of TCM dispensing granules. In view of the problems in the post-pilot stage and from the perspective of survival and development of enterprises, it is suggested that enterprises should establish a quality control system for the whole industry chain of TCM dispensing granules to reduce process costs and increase enterprise competitiveness, further increase the investment in scientific research, overcome the key technical problems of difficult varieties, actively and orderly promote the research of national standards, in order to ensure the integrity of clinical formula varieties, and establish and improve the efficacy evaluation mechanism of TCM dispensing granules, build a consistency evaluation system between TCM dispensing granules and decoction pieces. Government departments should strengthen the guidance, fully mobilize the enthusiasm of scientific research institutions, enterprises and hospitals, and explore the establishment of "government-industry-study-research-application" mode to promote the development of TCM dispensing granule industry.
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OBJECTIVE To build an “integration of drug storage and dispensing” intelligent drug validity management system in outpatient pharmacy, and to evaluate the effect of this system. METHODS The information technology was used to connect the drug information in the primary storage, the intelligent secondary storage and the rapid dispensing machine; an “integration of drug storage and dispensing” intelligent drug validity management system was constructed. At the same time, the implementation effects of drug validity management system in outpatient pharmacy of our hospital were evaluated one year before and after the construction of the system. RESULTS By using information technology, intelligent closed-loop management of batch number and expiration date information throughout the entire process of drug circulation in outpatient pharmacy of our hospital had been achieved, making it easy to track and trace drug information. After the establishment of the intelligent system, the time spent on managing drug validity every month was reduced from 103 people·h to 8 people·h; the number of near-expired drugs per month had decreased from (30.67±1.10)types to (17.67±1.17)types(P<0.05). CONCLUSIONS The intelligent drug validity management system in outpatient pharmacy based on the mode of “integration of drug storage and dispensing” makes the drug validity management in the outpatient pharmacy more scientific, reasonable and efficient.
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Traditional Chinese medicine dispensing granules(TCMDGs)is the new type of decoction pieces with the development of modernization of TCM, which has received mixed opinions since its practical application. In 2021, the national departments issued Announcement on Ending the Pilot Work of TCMDGs, marking the end of the 28-year pilot work of TCMDGs, and eligible TCM enterprises can produce TCMDGs after filing. However, this does not mean that the preparation process, quality standard and efficacy research of TCMDGs have been developed and matured, on the contrary, there are still some problems that need to be solved and gradually improved. For example, in the production process, there are problems such as unclear, unified and non-standardized preparation parameters. In terms of quality control, there are some problems such as lack of producing area regulation, variety selection and processing specification. In terms of consistency evaluation with traditional decoction, there are problems such as unclear relationship between the chemical constituents and pharmacological effects of the two. Therefore, in view of some prominent problems of TCMDGs at present, this paper takes the published literature as the main data source and combines the specific requirements of the code or technical standards such as the 2020 edition of Chinese Pharmacopoeia, Publicity of the Unified Standard on the Varieties of TCMDGs, Quality Control and Standard Formulation Technical Requirements of TCMDGs. The production process of TCMDGs, the origin and variety of raw materials, the processing of decoction pieces, the quality control standard and the consistency evaluation of formula granules and traditional decoction were sorted out and visualized by literature mining, data analysis and list comparison. Based on the analysis results, the following suggestions were made. In terms of preparation process, the completeness and standardization of process parameters should be strengthened. In terms of quality evaluation, attention should be paid to the relationship between the authenticity, variety, processing and quality of medicinal materials. In the consistency evaluation of formula granules and traditional decoction, the deep difference and mechanism between TCMDGs and traditional decoction were discussed by combining structural Chinese medicine, quality marker(Q-Marker) theory and physicochemical characterization, so as to provide reference for the application and development of TCMDGs.
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【Objective】 To analyze the blood dispatching of hospitals in Shijiazhuang area, in order to provide reference for blood dispatching policy of hospitals and ensure clinical blood supply. 【Methods】 The hospital blood dispatching data from 2018 to 2021 were queried through the blood center information management system (SHINOW9.5) and TMIS system, and the blood dispatching volume, frequency, variety and blood type distribution of hospitals at all levels were analyzed by SPSS statistical software. 【Results】 From 2018 to 2021, there were 1 196 times of blood dispatching in hospitals with a total volume of 4 648.5 U, showing a downward and then upward trend two years before and after the outbreak of COVID-19. As the main blood dispatching product, erythrocyte dispatching was 3 988 U, accounting for 85.79% of the total dispatching volume, with a dispatching rate of 2.99‰. The dispatching volume of red blood cells in secondary hospitals accounted for 86.13%.The dispatching rate of erythrocyte in secondary and tertiary hospitals was 1.03% and 0.06%, respectively, with significant difference(P<0.05). The dispatching rates of type A and AB red blood cells were 3.08‰ and 4.97‰, which were significantly different from those of type B and O red blood cells. 【Conclusion】 Blood dispatching has become an effective way to avoid blood waste and ensure emergency blood use in secondary and tertiary hospitals. In the actual operation, health administration department should strengthen supervision and hospitals should improve the blood dispatching process to ensure blood safety.
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@#The COVID-19 pandemic created the urgent need to use online and virtual platforms to facilitate development of skills and competencies as part of remote learning of students. MyDispense®, a learning management system developed by Monash University in Australia, is a practice-based online tool utilized by the University of the Philippines College of Pharmacy to teach dispensing skills in Dispensing and Incompatibilities courses (Phar 154 and Pharm 133). This commentary describes how MyDispense® was used as an online retail pharmacy simulation through the SEIPS (Systems Engineering Initiative for Patient Safety) model, with discussion on how the person, tasks, organization, tools and technology, and virtual environment work within the teaching and learning process in dispensing. The application of MyDispense® as a learning platform both in remote and traditional teaching can be further explored to maximize its features and utility.
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ObjectiveA rapid method for identification of chemical constituents in Puerariae Lobatae Radix dispensing granules was established in order to clarify the material basis. MethodThe chemical constituents of Puerariae Lobatae Radix dispensing granules was qualitatively analyzed by ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS/MS) under positive and negative ion modes, and the chromatographic conditions were on an ACQUITY UPLC HSS T3 column(2.1 mm×100 mm, 1.8 μm) with 0.1% formic acid aqueous solution(A)-0.1% formic acid acetonitrile solution(B) as mobile phase for gradient elution(0-4 min, 5%-10%B; 4-10 min, 10%-15%B; 10-20 min, 15%-16%B; 20-27 min, 16%-31%B; 27-33 min, 31%-59%B; 33-42 min, 59%-95%B; 42-42.1 min, 95%-5%B; 42.1-45 min, 5%B), the flow rate was 0.35 mL·min-1, the column temperature was 40 ℃, the injection volume was 5 μL, and electrospray ionization(ESI) was selected. Then these chemical constituents were comprehensively identified based on PeakView 1.2, PubChem, ChemicalBook, ChemSpider, comparative control profiles and literature information. ResultA total of 128 chemical constituents were identified from the dispensing granules, including 60 flavonoids, 26 organic acids, 7 glycosides, 6 coumarins, 3 nucleosides and 26 other compounds. By focusing on the cleavage patterns of flavonoids, organic acids, glycosides, coumarins, nucleosides and other compounds, 12 compounds that have not been reported in Puerariae Lobatae Radix species were identified from the dispensing granules. ConclusionThe established method can systematically and rapidly identify the chemical constituents in Puerariae Lobatae Radix dispensing granules, and cleared it composition is mainly flavonoids and organic acids. Laying a foundation for the study of the material basis, mechanism of action and clinical application of the dispensing granules.
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OBJECTIVE To provide a reference for establishing an automatic checking mode and improving the checking efficiency of the unit dose dispensing system of oral drugs in hospital. METHODS The automatic checking process reengineering team was established in our hospital. ECRSI method was adopted to sort out the verification process and mode of drug bags for the unit dose formula of our hospital through five principles of eliminating, combining, rearranging, simplifying and increasing, and the hardware series problem and the problem of excessive system false-positive proportion were optimized. The drug bags for the unit dose formula were randomly selected from 10 wards, the efficiency and external error rates of manual check and automatic checking mode before and after optimization were compared, and the false-positive reporting failure in automatic checking mode was also compared before and after optimization. RESULTS After the establishment of the automatic checking mode of the unit dose formula for oral drugs, the average checking time of drug bags was significantly shorter than that of manual checking mode in the other 8 wards except for cardiovascular and renal departments (P<0.05). After the optimization of the automatic checking mode, the average checking time of drug bags in all wards was significantly shorter than that in manual checking mode (P<0.05). Compared with before optimization of the automatic checking mode, the average checking time of drug bags was shortened by 0.43 s, and the average checking time of drug bags in half of the wards was shortened significantly (P<0.05). At the same time, the false-positive proportion decreased from 96.83% before optimization to 92.76% after optimization (P<0.05). The external error rate dropped from 0.039‰ in manual checking mode to 0.019‰ before optimization and 0.015‰ after optimization (P<0.05). CONCLUSIONS Based on ECRSI method, the automatic checking mode for the unit dose dispensing system of oral drugs can effectively reduce the average checking time of drug bags, reduce external error and improve the work efficiency of pharmacists.